Medical appliance for control of enemata



.0. F, LAMSON MEDICALAPPLIANCE FOR CONTROL OF ENEMATA Dec. 28, 1948.

Filed June 22, 1943 IN VEN TOR.

Patented Dec. 28, 1948 MEDICAL APPLIANCE FOR CONTROL OF ENEMATA Otis F.Lamson, Seattle, Wash. Application June 22, 1943, Serial No. 491,841

1 Claim. 1

This invention relates to a device for giving enemata, and for itsgeneral object aims to provide an appliance operative to precludepremature expulsion of the introduced fluid and thereby enable anattendant to positively control rectal injections.

Clarity in an understanding of this and other more particular objectsand advantages in view will perhaps be advanced by here stating thatenemata, as heretofore given, have required constant attention on thepart of a nurse or other attendant. As a result thereof and particularlywhere the demands upon an attendants time are relatively heavy-thiscondition being especially pronounced at the present time when hospitalsare forced to operate with far less than the usual number of help-thereis a not unnatural tendency to give enemata with undue haste. Aside fromthe pain to the patient caused by resulting bowel spasms, some patients,and this is especially evidenced in cases of a weak sphincter muscle ofthe anus, are entirely unable to retain the injected fluid, inconsequence expelling the same prematurely. Bed linen unnecessarilysoiled in this manner is one item which reflects itself in theexceptionally heavy laundering requirements of hospitals. Moreover, itbecomes self-evident that an expulsion of enema fluid before the samehas served its intended end of entirely loosening and softeningcongested feces within the bowel requires repetitive clyster operationswhich, if resorted to at too frequent intervals, can be quite harmful tothe patient.

Having the foregoing in mind, the present invention aims to devise anenema control appliance providing a clyster tip in association withmeans functioning to fixedly hold the same within the rectuminconsequence obviating need for an attendants presence during theenemaand additionally serving the ofiice of a seal, precluding prematureescape of the injected fluid. The device is, therefore, one whichenables an attendant to insert the appliance, set the same for anydesired degree'of slow-feed flow, and then go about his or her otherduties, giving other enemata if called for, during the relativelyprotracted time period required to best consummate a softening of thestool. It will be thus apparent that the appliance operates to largelyovercome spasms of the bowel and permit fluid, slowly injected, to reachthe upper limits of the colon. During the course of the enema, theordinary convalescent patient can, of course, make slight adjustments inthe fluid flow and can take the enema in comparative comfort with thebowel relatively relaxed as distinguished from the usual rigidity whichsympathetically follows when, as heretofore, it becomes necessary toexert a certain amount of effort in maintaining a contracted conditionof the external sphincter muscle of the anus.

The present invention provides a highly satisfactory method of givingnutrient enemata, also retention enemata which are indicated in someinstances and are performed by clamping the fluid-supply tube at a pointdistal from the appliance or, otherwise stated, at a point intermediatethe appliance and the container for the fluid. In the field of retentionenemata are, of course, barium injections which are resorted to forX-ray purposes and which, previous to the present invention, haveoccasioned considerable annoyance to the medical fraternity due topremature expulsion of the liquid-suspended barium.

The invention serves the further and important end of providing anassured method of giving enemata to patients with a colostomy, namely,an artificial anus; the procedure consists in the new method of fixedlyholding an enema tube 7 or, more properly, the rectal part thereof,within the rectum while coincidently sealing the anal canal againstleakage, and in the novel construction, adaptation and combination ofparts hereinafter described and claimed.

In the accompanying drawing: I

Figure l is a perspective view portraying the invention and showing thesame applied to a patient preparatory to giving an enema.

Fig. 2 is a detail longitudinal vertical section of one embodiment withthe view taken toan enlarged scaleand being fragmentary to the extentthat enema-fiow tubes leading to and from the appliance proper and anair-delivery catheter are broken away. In this view the balloon elementwhich performs the holding and sealing oflice of the invention is shownin its inactive normal condition by full lines and in its activeinflated condition by dotted lines.

Fig. 3 is a transverse vertical section taken to an enlarged scale online 3-3 of Fig. 2; and

Fig. 4 is a view similar to Fig. 2, excepting that I have shown asomewhat modified construction in which the air duct which suppliespressure air for inflating the balloon is molded into the enema-flowpipe as an integral part thereof.

First describing the invention as illustrated in Fig. 4 and whichconstitutes the now preferred embodiment, there is provided a rectalpipe denoted by the numeral 5 which is, or may be molded from, rubber orone of the various applicable plastics to provide a main canal 6 open atthe two ends and, along one side, present a longitudinal air duct '1.This duct connects toward the rear end of the pipe with a laterallyprojecting nipple 8 and extends forwardly to a point somewhat short ofthe forward limit of the pipe whereat the same terminates in a surfaceoutlet 9. 'rhegpip iigliteiihirially beaded "or dthe'rwise suitablyformedaa-for example, "by the instrumentality of embedding male hosefittings in the two ends to accommodate the attachment, to the" rear endthereof, of a supply hesewfllifrom afluid container (not shown) and, tothe forwarm'end, of a. clyster tip H forming the enema nozzle and havingthe usual vent or vents H'i' 1'? denotes an adapter embedded intheregposed; nipple 18, and attached thereto is a flexible catheter ldto which is connected an air syringe l4 having tl-ie usual one-way valvepermitting atmospheric air to i -bec drawni fin'tot Cthenb'ulb 1whilelztrappirig txthe sameagainstescape. B'I'here is iappli-eds-labouttheopipezfii tol fiiitend in:i'oppositeidireotions beyondeitheEBLlIKJpGItIFQ- Ia f sl'ee've i=- td. be'zhereinafterutermedraballoonheld to the pipe by seizings iii-56 appliedzs'at "the :"IlidHextremities. .l Being sar-ranged .rto snorcmallyioccupya'icollapsedilpositiomcsaidrballoonsis zinflatabl'etibyzitheipressurerinfluence ofs airazina'ected ithrough the iduet"! zandmllienaso ainflated, assumesithe shape shown :by dotted 1 lines ziriz'Ei'g.-2Jandby1 run :linesxinFF-ig) 1. *i'lheiballoorrrissdeisirablyiproducedizfrom aax'cylindei sofzfelastici rubberr butr 'teissselfievidentzithatotlie s'anfe :admit's pfhthe'cuselofzany'1flexible:.nonaporons:1material suchna-s rpaaachutersilkswhich,nperfnrceyawould fenrbodylthednecessary ifolds when collapsed'stoenableczthes same Ito: expandimnderiiniection (or pressure-air.

toccupyingzarposition tto ithef rarf-bf3th balloon and fittingif=reely2uporr the pipeist aepad t :1 indr- .catedzas wheingspfnspongei' rubber iandaabutting ctlie :oinierriace izthereofisise a disc'18. median; disc, composedzpfr'rubberimoreildense tin ltexture thanntha'tiof Itheapad; n'smrangeditorsnuglyoencompass lithe pipe andinztheiuse ofrthe applianee'irri'ction --ally;.grips:' the latter.

."Nowrreferringitormgsfl and 3pitswillrbeseen that substantiallytheo'nly izharige'ifromiithes con struction ofFigs-4iiliesitin;rthetfactrofiiprdduning sthe ipineyas: 5',=with a-isurfacerchannel zld corirel spondingwas. torlengthiyvithitheidubtr] andwhinh is arrangedt-to lhavedthe roatheterui=3 .=-snileiy rfit rthereinwith the: z18Itt81 S-1Outlet-: Bnd .leadingidimectl-y to ithe.=balloon,-a? *seizingn-Mbbeing applied .about :the :pifiErEXtQl-iOIlY 50f? the.friction :.disc-,-=i18 IOI'vWhiGh is -to -say: at a=point rearwardlymemoyed items the; discatdaugment thehseizin-g. 4 Sin lfiliimg .theeatheterein position.

I z'Invlthesuse oi ither appliance ithernectahpipeawith its}; attached3013 51181? tip, 1 and wi-th the nballo'on deflated, is inserted s'within; thepirectum :of l the patient to locateathehballooni fullyraneinchaibewyondlthe: external splnnctervmuscle of: i-the anus,andhth-e attendantiihen:operates. ithesyringeato rinflateztheballoomlsuchinflation occasioningf no discomfort to the :patient. Theattendant then excus -tension upon the rectalzrpipe-zsinna withfdifaiwal:directioni toxpull' the fiexpanded-rballoon isnuglseagainsttherinternal'sphincter'imusclerand fixes the appliance in this position by bringing:themad l "L: snugiyi againstc thel anus-i and :sli'din g Ithe .frictiongdisc forwardly lto xhave'inthei same press nagainstthe mad, uithus'zholding :lthe :ipad against shiftingaand causingsithe anal'rcanaletobe sealed by the stopper action of the balloon. The enema may be nowgiven by attaching the supply hose ii! to the rectal pipe and suspendingthe enema can or bottle at a relatively low 5 elevation of, say, 12 to16 inches, assuring a slow injection of the fluid and thereby permittingthe latter to work gradually through the entire colon and effectivelyloosen and soften the feces with- "outideveloping bowel spasms.

"Iheappliance'maybe readily withdrawn for defecation by theinstrumentality of removing the syringe from the catheter to allowescape of \ltherzpressure 'airi from the balloon. A valve for itliispurpose might of course be applied to ob- 5 viate the need for removingthe syringe. Syringes are now produced to meet manifold require-"mentsandthere-is available, and commonly used, a bulb including anon-return checl:-accomplis hing the pumping function of the syringe- 20and also equipped with a release valve to exhau'st the pumped airwhen itis desired to relieve" the pressure. 'Consequently, a syringe-oi thistype,'. and which I prefer to employ-obviates notonly aneedforremoval-of the syringe when 5 it --is desi=redtaexhaust the pressure airin eifectuating a deflation of the balloon, but also obviates-thetneedfor-anexhaust valve separate and apart from'l tlie syringe. It willbeself-evident that-an exhausting-of the-air will causethe balloonitore-turn to the: deflated condition in which lit is shown in.- Fig.: 2(fulllines) anddn Fig.4 and, rs'-o :deflated can be. passed freelythrough uthe anali canal tofclear the latter and permit th'ea'fpatient-to'voidfthe softened feces by natural d'cfecation.

:It should,s perhaps, be mentioned that in lieu --of'.:a; cushionrubberzpad no discomfort would be iattacheditotithe femployment of ra ninflexible :memberi dfh'ardrubber or plastidmolded to have in 'itsfrontali face, considered .in horizontal section,

ldescriberarr-Ielliptical:profile. There is thisracl--vantagevvhichcwouldfollow from the used such :aaplecepbwcomparison withthe cushion rubber palinnamelyithex-ease .incleaningandwhichzobiziaizeslthe-need, ordesirability, of applyinga sheet'of?disposable'tissuerover the frontal faceofithe "rubber-pad.

10f epairticulariimportat the present time when rhospital's,tsespecia'lly as to nurses, are -shor-t- .ehanded; iitf'c'anvbeicons'er-vatively estimated that ithelnse ofriftheupresent appliancewithin a' 560- fbEdZhOSDitflI-Calfl save" upwards of 30 nursing hours aday. To the patient requiring eneniata, avhetheriindicatedras a'therapeutic treatment or 'r'esortedzto :fpruprophylactic reasons topreclude :thedev'elopment of conditions traced toconstipathezzin'vention may-be said to introduoe an entirelynewtechnique to' which the benefi-ts'hereiinbefore'ienumerated can beattributed.

I'It isrmy intention that no limitations beimplied as various change'sbeyond'those-herein spe- -dificallyreferred to will, without 'departingfrom 'rthefispirit of the invention, readily occur to those 'verseii inthe 'airt.

What I' claim is Antapplianeefor' the controlof enema ta compri's'ingthe'combination of a rectal pipe providing a main-fluid canal arrangedto be inserted by its fOI W'ard-"end"through-the 'anal canal into" thelower regionee patien'ts bowel and being scammed-connect by-its rear endwith anen ema t'ubees'aid pipe wheninsertedexposingits said rearend-beyond the distal endof said anal canal;'an

iiiflatableelement car riedupon' the forwarden d 7'5 'l'lf th e*pipeancnarrangeaand adapted td be baL looned by injection of pressureair from a normally collapsed condition permitting the same to passfreely through said anal canal into an expanded compass exceeding thatof the internal mouth of the anal canal, said element being comprised ofa single-thickness fistular-shaped sheet of elastic rubber sleeved oversaid forward end of the pipe and, when collapsed, finding a snug fitupon the latter and having its end extremities made fast to the pipe toprovide a seal against the escape of air introduced to the element forballooning the same; ,an air duct isolated from said main fluid canal ofthe .pipe and extending longitudinally frointhe outer end of the pipe toterminate in an outlet port giving access to the interior of theballoon, the admission end of said air duct being arranged forconnection with a source of controlled. pressure air; and means alsocarried upon the pipe and in the use of the appliance operating to fitsnugly against the anus of the patient and in consequence hold theinflated balloon against said internal mouth of the anal canal.

OTIS F. LAMSON.

5 REFERENCES CITED The following references are of record in the file ofthis patent:

UNITED STATES PATENTS

